INTRODUCTIONThe essential components of antenatal care are screening of pregnant women for high risk factors, performing essential laboratory investigations and provision of advice regarding personal hygiene, nutrition, immunization and regular follow up visits. Literature review suggests that women with regular antenatal visits have better pregnancy outcome than their counterparts. 1The reported percentage of antenatal care coverage in India by UNICEF was 37% for four visits and 74% for at least a single visit (2014), institutional delivery rate of 47% and delivery by trained person was 52%.2 Despite ongoing efforts to improve maternal and child health in developing countries, mortality rates remain much higher than in developed countries.3 Women in developing ABSTRACTBackground: The rapid escalation of cellular network coverage and expansion of mobile phone usage has opened up a new way of deploying health services. The mobile app with message facilities help in imparting health education regarding nutrition, iron and folic acid prophylaxis, tetanus toxoid immunization, danger symptoms and signs during pregnancy etc. Present study aimed to improve maternal health and pregnancy outcome by optimum utilization of antenatal, natal and postnatal care services, with the use of mobile phone as a medium of communication between health care provider and community in rural area. Methods:The prospective randomized control study, with two hundred pregnant women each, coming for antenatal visit and having personal mobile phone facility, were randomly allocated to control and intervention group. Control group women received routine antenatal care and advice as per hospital protocol. In addition to routine care and advice, intervention group received mobile phone calls, as reminders about next visit and text messages (SMS) on important aspects of antenatal care at regular intervals. The primary outcome indicators of the study were percentage of pregnant women coming for at least four antenatal visits, percentage of institutional delivery and postnatal checkups. Results: Women in the intervention group had significantly higher number of antenatal visits, consumption of iron tablets, tetanus toxoid immunization, institutional deliveries and postnatal check-ups as compared to the control group. Conclusions: In the present study, the mobile phone intervention, significantly increased the percentage of women receiving the recommended four antenatal visits and showed a trend towards more women receiving preventive health services. Study gathered good evidence that m-Health tools present an opportunity to influence behaviour change and ensure that women access prevention services, including antenatal, natal and postnatal care. Mobile technology, specifically SMS can be successfully used to extend health information services to pregnant women.

Background:Health research training is an essential component of medical education and a vital exercise to help develop physician research skills.Objectives:This study was carried out to assess the knowledge, attitude, and practices towards health research amongst the postgraduate students of Pravara Institute of Medical Sciences University of central India.Materials and Methods:A cross-sectional study was carried out from August to October 2012. A total of 116 postgraduate students were interviewed. Knowledge, attitude, and practices related to health research were assessed using a predesigned, pretested and validated questionnaire. Results were analyzed in the form of percentage and proportions whenever appropriate.Results:In present study, the concept of research hypothesis was known to only 18.9% of the postgraduate students, whereas 17.2 and 21.5% students knew the full form of MEDLARS and MEDLINE respectively. Majority (91.4%) students believed that patient outcome improves with continued medical research and 70.7% are willing to participate in workshop for research methodology. Lack of time due to vast curriculum of postgraduate subjects (59.5%), lack of research curriculum (25%), and inadequate facilities (25.8%) were stated as major obstacles for pursuing research.Conclusion:Postgraduate students have inadequate knowledge, but have positive attitudes towards health research. Postgraduate training and research facilities at the institution need to undergo major transformation in order to encourage meaningful research by postgraduate trainees.

Background:The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.Aims:The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).Materials and Methods:The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.Results:In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.Conclusion:Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

Background: Preeclampsia and eclampsia have been recognized as clinical entities since the times of Hippocrates. Pregnancy induced hypertension (PIH) is one of the commonest disorders associated with the increased risk of maternal and fetal complications. It is reported in the world literature that the incidence of eclampsia is on the decline, but still a menace in developing countries. Objectives: To study the maternal and foetal outcome in pregnancy induced hypertension. Material and Methods: A prospective randomized study was carried out from February 2009 to January 2010 in the Department of Obstetrics and Gynecology of Pravara Rural Hospital, Loni, India. A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested interview tool was used to collect necessary information such as detailed history, clinical examination findings and investigations performed. Results were analysed using SPSS 13.0 Results: In the present study, the overall incidence of PIH was 8.96%, which includes preeclampsia in 7.26% and eclampsia in 1.70%. Preterm labour was the commonest maternal obstetrical complication observed in 18% of mild PIH and 48% of severe PIH cases. Prematurity was the commonest foetal complication seen in 17.99%, 47.62% and 52.63% of mild PIH, severe PIH and Eclampsia cases respectively. Conclusion: Pregnancy induced hypertension is a common medical disorder seen associated with pregnancy in the rural population, especially among young primigravidas, who remain unregistered during pregnancy. Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.

Twin gestation is considered as high risk pregnancy due to associated high maternal morbidity and perinatal mortality in comparison with singleton pregnancies .Overall, the rate of twin gestation is on rise due to inadvertent use of ovulation induction drugs in assisted reproductive techniques. This observational study was carried out to find the maternal and perinatal outcome in 100 cases of twin gestation delivered at tertiary care referral hospital over a period of fifteen months. It was observed that the incidence of twins was 1.49 % .Seventy six percent cases were booked and attended antenatal clinic on regular basis .Preterm labour (84%) was the commonest obstetric complication ,whereas ,nutritional anemia (66%) and pregnancy induced hypertension (18%) were the commonest medical complications .The rate of caesarean section was 33%.There was no serious maternal morbidity or mortality .There were 35 perinatal deaths ,of which 20 were early neonatal deaths. Extreme prematurity (37%) and very low birth weight (33%) predisposed majority of perinatal deaths. Causes of neonatal deaths were respiratory distress, fulminant septicemia ,pulmonary hemorrhage and DIC. Judicious use of ovulation induction drugs can reduce the incidence of twin gestation. Early diagnosis of twin gestation with its chorionicity, careful monitoring for fetal wellbeing throughout the pregnancy ,regular antenatal checkups, adequate rest, good diet, cervical encirclage in selective cases, maternal gluco-corticoids therapy in preterm labour, short term tocolysis and institutional delivery having level III neonatal back up facilities can improve the maternal and perinatal outcome in twin gestation.